నైరూప్య

Analysis of Postoperative Bleeding in A Case of Appendiceal Mucinous Adenocarcinoma Complicated with Liver Dysfunction: A Case Study

Mingkun Sun, Xiaohua Niu,Wenzhong Mo,Haiyang Xin,Ling Qi2,Chaoming Tang

Background: Appendiceal malignant tumors are rare in the clinic, and the incidence rate of gastrointestinal tumors is only approximately 0.5%. Our aim is to describe our experience with this rare disease and to increase knowledge on the diagnosis and treatment of appendiceal malignant tumors.

Case presentation: We report the case of a 69-year-old woman who was admitted to the hospital due to dyspepsia. The patient was a carrier of hepatitis B virus, and liver dysfunction was diagnosed preoperatively. Abdominal enhanced computed tomography and colonoscopy showed that the appendix was significantly enlarged and dilated, and effusion and appendicitis were observed. Mucinous adenocarcinoma and appendiceal abscesses were not excluded because of the lack of specificity, which makes it difficult to diagnose the disease before a surgery. Laparoscopic appendectomy was performed, and a rapid frozen pathological examination showed a mucinous tumour of the appendix. Intraperitoneal hyper thermic chemotherapy with cisplatin was administered. The patient had abdominal haemorrhage on the fifth day after the surgery. After active treatment, she was discharged from the hospital 19 days after the surgery.

Conclusions: The diagnosis of appendiceal malignant tumors mainly depends on preoperative imaging and microscopic results, and highly suspected patients, rapid pathological examination is needed during the operation, and so on. Notably, for elderly patients with hepatitis B infection and liver dysfunction, there is a probability of postoperative bleeding.